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Use of Albumin in burns resuscitation

Nikahat Jahan nikahat at gmail.com
Fri May 20 18:55:40 BST 2011

Dear all
There are several studies that recommend the use of colloids- 5% albumin in
burn resuscitation- esp after the first 24 hrs. The original Parkland
formula had included 5% albumin from day 2. Few other formulae like the
Muir-Barkley formula and Modified Brooke formula include colloids.

The most recent cochrane review also concludes that *" There is no evidence
from RCTs that resuscitation with colloids reduces the risk of death,
compared to resuscitation with crystalloids, in patients with trauma, burns
or following surgery. As colloids are not associated with an improvement in
survival, and as they are more expensive than crystalloids, it is hard to
see how their continued use in these patients can be justified outside the
context of RCTs."*

Cochrane Database Syst Rev. <http://www.ncbi.nlm.nih.gov/pubmed/21412866> 2011
Mar 16;3:CD000567.
Colloids versus crystalloids for fluid resuscitation in critically ill
Perel P<http://www.ncbi.nlm.nih.gov/pubmed?term=%22Perel%20P%22%5BAuthor%5D>
, Roberts I<http://www.ncbi.nlm.nih.gov/pubmed?term=%22Roberts%20I%22%5BAuthor%5D>

In view of the phenomenon of "Fluid Creep" and studies that show that
colloids reduce it, what would be the right way to resuscitate patients with
extensive burns- to use 5% albumin or avoid it?

Lt Col Nikahat Jahan
Classified Spl (Anaesthesiology)
Indian Army

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